Seeking Traditional Health Practitioners and Use of Complementary/Alternative Medicines in the Management of Movement Disorders in Africa: A Multicenter Continental Study

Background: Traditional health practitioners (THP) and complementary and alternative medicines (CAM) play a well-recognized role in Africa. However, their role in treating movement disorders (MD) remains poorly studied. Objective: This large multicenter continental study aimed to investigate the prevalence of seeking and consulting THPs and using CAMs among people with MDs in different African countries and the associated factors of their use. Methods: This study involved 12 sites within 11 African countries. We developed and distributed a structured questionnaire that documented frequency, attitudes, beliefs, and factors related to patients' engagement with THPs and use of CAMs. Results: We surveyed 1158 participants with MDs from 11 African countries in different regions of the continent. Overall engagement with THP and CAM use were reported in about a third (319 [27.5%] and 356 [30.7%], respectively) of individuals with MDs, which was associated with delayed diagnosis and medical treatment initiation and significantly varied by country, reaching up to 80%, particularly among individuals from sub-Saharan Africa (SSA) and those with hyperkinetic MDs. Common contributing factors included unavailability, unaffordability, and lack of access to health services; misconceptions regarding disease nature; lack of curative response to medications; feeling of stigma; rural residence and patients' ethnicity; and levels of education and employment. These factors were more pronounced in patients in SSA. Conclusion: Seeking THPs and using CAM are widespread practices in African countries and have a negative impact on patients' care. Their use is related to inadequate health-care services, misconceptions, and other factors, which are modifiable and mandate immediate and comprehensive actions.